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Dr. Matthew J. Bruno, D.D.S., M.S. Orthodontics and Dentofacial Orthopedics PATIENT HISTORY (Confidential) Date PATIENT INFORMATION Patient s Name Prefers to be called Birthdate / / Age Sex Social
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How to fill out patients name prefers to?

01
Start by locating the designated field for the patient's name on the form or document you are filling out.
02
Enter the patient's full legal name as it appears on their identification or official documents.
03
If the form asks for the patient's preferred name, ask the patient directly how they prefer to be addressed or referred to.
04
Write down the patient's preferred name exactly as they have specified, ensuring that it matches their wishes accurately.

Who needs patients name prefers to?

01
Healthcare providers and medical staff: Knowing how a patient prefers to be addressed can help healthcare providers create a more personalized and respectful experience for the patient.
02
Administrative staff: Having the patient's preferred name on record can help administrative staff communicate with and address the patient correctly.
03
Other patients: In some situations, patients may interact with each other, and knowing each individual's preferred name can foster an environment of inclusivity and respect.
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Patients may prefer to go by a nickname or a shortened version of their name.
Healthcare providers or facilities may be required to file patients name preferences for record-keeping purposes.
To fill out patients name preferences, ask the patient how they would like to be referred to and document it in their medical records.
The purpose of patients name preferences is to respect the patient's wishes and provide personalized care.
The preferred name that the patient wishes to go by.
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